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Background Remimazolam is a newer benzodiazepine with properties of rapid onset, short duration of action, and fast recovery. Our study was to evaluate the effects of different doses of remimazolam combined with alfentanil in colonoscopic polypectomy. Methods One hundred twenty patients were randomly divided into four groups: alfentanil and propofol (AP) group, alfentanil and remimazolam 0.1 mg/kg (AR1 group), 0.15 mg/kg (AR2 group), or 0.2 mg/kg (AR3 group). Patients in the four groups received alfentanil 10 μg/kg, followed by propofol 2 mg/kg and three dosages of remimazolam. Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scale, heart rate (HR), oxygen saturation (SpO 2 ), respiratory rate (RR), bispectral index (BIS) values and mean arterial pressure (MAP) were collected at intervals of 5 min and analyzed at different time points: before anesthesia (T0), 5 min (T1), 10 min (T2), 15 min after anesthesia (T3) and at the end of surgery (T4). The average MAP was calculated utilizing the average of all MAP values. The primary outcome was the success rate of sedation. Secondary outcomes included time to full alert and adverse events. Results The success rate of sedation was 100% among the four groups. The incidence of hypotension was significantly decreased (all P  < 0.05) and the average MAP was higher in AR1-AR3 groups than AP group (all P  < 0.001). None of the patients developed bradycardia or hypertension during surgery in all study groups. BIS values were higher (all P  < 0.001) and the time to full alert was statistically shorter in AR1-AR3 groups (all P  < 0.05) compared with the AP group. The MOAA/S score in AR1 was higher than AR2 ( P  < 0.05) and the AR3 group ( P  < 0.05) at T1 and BIS values in the AR1 group were significantly higher than AR3 group ( P  < 0.05) at T4. Conclusions Remimazolam combined with alfentanil have a non-inferior sedative effect than propofol during the colonoscopic polypectomy. Moreover, this combination of two short-acting drugs might be a safer alternative. Trial registration The clinical trial was registered on (16/05/2021, ChiCTR2100046492).

Background Pulse perfusion index (PI) reflects blood perfusion. It has been reported that PI can be used to evaluate the effect of nerve block, but currently, it is mainly focused on awake adults. In pediatric general anesthesia, it has been reported that PI can evaluate the effect of the sacral block. Still, there is a lack of relevant research on the impact of brachial plexus blocks. Our objective is to assess the prediction effects of PI on the success of supraclavicular brachial plexus block in pediatric patients under sevoflurane or propofol general anesthesia. Methods/design This is a mono-center, parallel, 2-arm randomized superiority trial. One hundred four children aged 1 month to 12 years who undergo upper limb surgery will be enrolled in this study. According to anesthesia induction and maintenance medication, they will be divided into sevoflurane and propofol groups. The PI values of the index and little finger will be recorded on the blocked and non-blocked sides of supraclavicular brachial plexus block (SCB) in all children. The primary outcome is to assess the effects of PI on the success of supraclavicular brachial plexus block in pediatric patients under sevoflurane or propofol general anesthesia. The secondary outcome includes mean arterial blood pressure (MAP), heart rate (HR), and correlation between baseline PI and 10 min after SCB (PI ratio). Discussion This trial will provide evidence on the changes in PI after SCB in sevoflurane or propofol anesthesia in children. SCB may lead to changes in PI values under sevoflurane or propofol anesthesia. After the children wake up at the end of the surgery, the changes in PI values on the block side and non-block side may be helpful to judge the effect of nerve block when excluding the influence of anesthetics. Trial registration ClinicalTrials.gov NCT04216823 . Registered on 15 July 2020.

Accurate seed counting is an essential task in agricultural research and farming, supporting activities such as crop breeding, yield prediction, and weed management. Traditional manual seed counting, while accurate, is time-consuming, labor-intensive, and prone to human error, particularly for large quantities of micro-sized seeds. This study developed two automated computer vision approaches integrated into a mobile application (app) for seed counting: one utilizing image processing (IP) and the other based on deep learning (DL). These methods aim to address the limitations of traditional manual counting by providing automated, efficient alternatives. The IP-based method demonstrated high accuracy comparable to manual counting and offered substantial time savings. However, its reliance on controlled environmental conditions, such as uniform lighting, limits its versatility for field apps. The DL-based method excelled in speed and scalability, processing counts in as little as 0.33 seconds per image, but its accuracy was inconsistent for visually complex or densely clustered seeds. Both automated methods significantly enhance the efficiency of seed counting, providing a practical and accessible solution for various agricultural contexts. The integration of these methods into a mobile app streamlines seed counting for laboratory research, field studies, seed production, and breeding trials, offering a transformative approach to modernizing seed counting practices while reducing time and labor requirements.

Sepsis-Associated Encephalopathy (SAE) is common in sepsis patients, with high mortality rates. It is believed that neuroinflammation is an important mechanism involved in SAE. High mobility group box 1 protein (HMGB1), as a late pro-inflammatory factor, is significantly increased during sepsis in different brain regions, including the hippocampus. HMGB1 causes neuroinflammation and cognitive impairment through direct binding to advanced glycation end products (RAGE) and Toll-like receptor 4 (TLR4). Electroacupuncture (EA) at Baihui (GV20) and Zusanli (ST36) is beneficial for neurological diseases and experimental sepsis. Our study used EA to treat SAE induced by lipopolysaccharide (LPS) in male Sprague–Dawley rats. The Y maze test was performed to assess working memory. Immunofluorescence (IF) and Western blotting (WB) were used to determine neuroinflammation and the HMGB1 signaling pathway. Results showed that EA could improve working memory impairment in rats with SAE. EA alleviated neuroinflammation by downregulating the hippocampus’s HMGB1/TLR4 and HMGB1/RAGE signaling, reducing the levels of pro-inflammatory factors, and relieving microglial and astrocyte activation. However, EA did not affect the tight junctions’ expression of the blood–brain barrier (BBB) in the hippocampus.

Background Ferroptosis and inflammation are involved in cancer progression. The aim of this study was to identify inflammation-associated ferroptosis regulators in hepatocellular carcinoma (HCC). Methods FerrDb database was searched for ferroptosis-related genes. RNA sequencing data and clinicopathologic information of HCC patients were downloaded from the Cancer Genome Atlas (TCGA) database. Weighted gene co-expression network analysis was applied to obtain the genes probably involved in inflammation-associated ferroptosis. Univariate Cox regression analysis was conducted to screen prognostic genes, and 10 machine learning algorithms were combined to find the optimal strategy to evaluate the prognosis of the patients based on the prognosis-related genes. The patients were divided into high risk group and low risk group, and the differentially expressed genes were obtained. Thymosin beta 4 X-linked (TMSB4X) was overexpressed or knocked down in HCC cell lines, and then qPCR, CCK-8, Transwell, flow cytometery assays were performed to detect the change of HCC cells’ phenotypes, and Western blot was used to detect the change of ferroptosis markers. Results 157 genes related to inflammation and ferroptosis in HCC were obtained by WGCNA. rLasso algorithm, with the highest C-index, screened out 29 hub genes, and this model showed good efficacy to predict the prognosis of HCC patients. The patients in high risk group and low risk groups showed distinct molecular characteristics. TMSB4X was the most important gene which dominated the classification, and it was highly expressed in HCC samples. TMSB4X promoted the viability, migration and invasion, and repressed ferroptosis of HCC cells. Conclusion The risk model constructed based on the inflammation-associated ferroptosis regulators is effective to predict the clinical outcome of HCC patients. TMSB4X, involved in inflammation-associated ferroptosis, is a potential biomarker and therapeutic target for HCC.

Dopamine is an important neurotransmitter that plays a biological role by binding to dopamine receptors. The dopaminergic system regulates neural activities, such as reward and punishment, memory, motor control, emotion, and sleep–wake. Numerous studies have confirmed that the dopaminergic system has the function of maintaining wakefulness in the body. In recent years, there has been increasing evidence that the sleep–wake cycle in the brain has similar neurobrain network mechanisms to those associated with the loss and recovery of consciousness induced by general anesthesia. With the continuous development and innovation of neurobiological techniques, the dopaminergic system has now been proved to be involved in the emergence from general anesthesia through the modulation of neuronal activity. This article is an overview of the dopaminergic system and the research progress into its role in wakefulness and general anesthesia recovery. It provides a theoretical basis for interpreting the mechanisms regulating consciousness during general anesthesia.

Neck pain with high incidence and recurrence rates significantly impairs patients' quality of life and imposes a considerable economic burden. Traditional Chinese medicine therapies such as Yijinjing exercise and Tuina have shown promising efficacy in alleviating the local symptoms of neck pain. However, there is currently insufficient high-level evidence to robustly support these findings. This study aims to evaluate the efficacy and safety of combining Yijinjing exercise with Tuina for the treatment of neck pain. PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP Chinese Science and Technology Periodicals Full-Text database, and Wanfang database will be systematically searched for all relevant randomized controlled trials (RCTs) from their inception to September 2025, without language or publication status restrictions. The Cochrane Risk of Bias 2 assessment tool will be used to evaluate the risk of bias in the included studies, and the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system will be employed to grade the quality of evidence. Heterogeneity will be evaluated through I statistics and Cochran's Q test: a fixed-effect model will be used when I <50% and P≥.01. If I ≥50% or P<.01, subgroup analysis will be conducted. When heterogeneity still exists, sensitivity analysis or exploratory subgroup analysis will be performed. If it cannot be explained ultimately, the random-effects model will be adopted and the GRADE evidence level will be reduced. As of June 2025, we have completed the preliminary screening of titles and abstracts for 573 studies. The full-text screening is expected to be completed by September 2025, and data analysis is planned to be completed by December 2025. About two-thirds of the studies were published after 2015. Geographically, the samples in the studies were highly concentrated in Asia. The results were comprehensively developed around the core outcomes. The primary outcome was presented by changes in the visual analog scale. The secondary outcomes were evaluated by the neck disability index, self-rating anxiety scale score, mean vertebral artery blood flow velocity, and Cobb angle. If the results of this study confirm the effectiveness of massage combined with Yijinjing, it can provide a direction for the nonpharmaceutical treatment of neck pain. However, some studies have risks of bias such as insufficient standardization of massage operations and difficulty in implementing blinding methods. The expected heterogeneity is significant due to differences in intervention plans and patients' cultural backgrounds, and the original RCTs are few and regionally concentrated, with limited extrapolation of conclusions. In the future, it is necessary to optimize the plan and supplement data through high-quality multicenter research to enhance reliability. PROSPERO CRD420251026508; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251026508. DERR1-10.2196/77864.

With concerns of diminishing fossil fuel reserves and environmental deterioration, great efforts have been made to explore novel approaches of efficiently utilizing bio-renewable feedstocks to produce chemicals and fuels. 5-Hydroxymethylfurfural（HMF）,generated from dehydration of six-carbon ketose, is regarded as a primary and versatile renewable building block to realize the goal of production of these high valued products from renewable biomass resources transformation. In this review, we summarize the recent advances via green routes in the heterogeneous reaction system for the catalytic production of HMF from glucose conversion, and emphasize reaction pathways of these reaction approaches based on the fundamental mechanistic chemistry as well as highlight the challenges（such as separation and purification of products, reusing and regeneration of catalyst, recycling solvent） in this field.

Objective To evaluate the analgesic efficacy of quadratus lumborum block (QLB) in adults undergoing nephrectomy. Design Systematic review and meta-analysis. Patients Adult patients (≥18 years of age) received nephrectomy under general anesthesia. Methods We searched PubMed, Embase, the Cochrane Library, and Web of Science on January 10, 2022, including randomized controlled trials that evaluated the analgesic efficacy of QLB for patients undergoing nephrectomy. Results A total of 12 randomized controlled trials (N = 821 patients) were included in the study. Compared with the non-block, single-shot QLB reduced postoperative opioid consumption (mean difference [MD], −8.37 mg intravenous morphine equivalent; 95% confidence interval [CI], −12.19 to −4.54 mg) and pain scores at 2 hours, 6 hours, 12 hours, and 24 hours at rest and during movement after nephrectomy. Single-shot QLB also prolonged the time to first analgesic request (MD, 6.44 hours; 95% CI, 2.23 to 10.65 hours), shortened the length of hospital stay (MD, −0.32 day; 95% CI, −0.55 to −0.09 day), and decreased the incidence of postoperative nausea and vomiting (risk ratio, 0.48; 95% CI, 0.36 to 0.65). Compared with continuous epidural anesthesia, repeated QLB could provide comparable postoperative analgesic benefits. Conclusions Single-shot QLB provided a statistically significant but clinically small improvement in postoperative analgesia and recovery for patients undergoing nephrectomy. The QLB would be beneficial as part of multimodal analgesia. Future research might need to determine which approach of QLB is superior for postoperative analgesia after nephrectomy.

Machine vision–based herbicide applications relying on object detection or image classification deep convolutional neural networks (DCNNs) demand high memory and computational resources, resulting in lengthy inference times. To tackle these challenges, this study assessed the effectiveness of three teacher models, each trained on datasets of varying sizes, including D-20k (comprising 10,000 true-positive and true-negative images) and D-10k (comprising 5,000 true-positive and true-negative images). Additionally, knowledge distillation was performed on their corresponding student models across a range of temperature settings. After the process of student–teacher learning, the parameters of all student models were reduced. ResNet18 not only achieved higher accuracy (ACC ≥ 0.989) but also maintained higher frames per second (FPS ≥ 742.9) under its optimal temperature condition (T = 1). Overall, the results suggest that employing knowledge distillation in the machine vision models enabled accurate and reliable weed detection in turf while reducing the need for extensive computational resources, thereby facilitating real-time weed detection and contributing to the development of smart, machine vision–based sprayers.